膀胱肿瘤中评估肌肉侵犯的膀胱成像报告和数据系统的验证。
Validation of vesical imaging reporting and data system for assessing muscle invasion in bladder tumor.
机构信息
Departmet of Radiology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, Korea.
出版信息
Abdom Radiol (NY). 2020 Feb;45(2):491-498. doi: 10.1007/s00261-019-02190-1.
PURPOSE
To retrospectively determine the diagnostic values of vesical imaging reporting and data system (VI-RADS) score for detecting muscle-invasive bladder tumors.
METHODS
This study included 297 consecutive patients with 339 tumors who previously diagnosed and subsequently underwent multiparametric MR imaging between January 2015 and March 2019. Two radiologists assessed the scores of muscle-invasive tumors using cutoff values of ≥ 4 and ≥ 3. Cutoff values for VI-RADS scores were estimated from the best operating points of the areas under the receiver operating characteristic curve analyses using the Youden J statistic. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated to assess the utility of VI-RADS for diagnosing muscle-invasive tumors.
RESULTS
Inter-observer agreement was excellent for three different MR imaging type at lesion level (k = 0.89 for T2W, k = 0.82 for DW, and k = 0.85 for DCE). At a cutoff value of 4, T2W and DW imaging had a diagnostic accuracy of 79.3% (269/339) for tumor lesions with muscle invasion, which was similar to an overall score of 80.2% (272/339). The overall VI-RAD score showed 80.2% accuracy (272/339), with a cutoff value of ≥ 4, yielding 91.3% sensitivity (85/93), 76.0% specificity (187/246), 83.3% PPV (85/102), and 78.9% NPV (187/237). When we considered an arbitrary overall score of ≥ 3 as the cutoff value, the accuracy was 63.7% (216/339); sensitivity, 94.6% (125/132); specificity, 43.9% (91/207); PPV, 51.6% (125/242); and NPV, 63.7% (91/97).
CONCLUSION
VI-RADS has an overall good performance in the diagnosis of muscle-invasive tumors.
目的
回顾性分析膀胱影像报告和数据系统（VI-RADS）评分诊断肌层浸润性膀胱癌的价值。
方法
本研究纳入了 2015 年 1 月至 2019 年 3 月期间连续 297 例 339 个肿瘤患者，所有患者均经术前多参数磁共振成像检查，由 2 位放射科医生采用≥4 分和≥3 分的截断值评估肌层浸润性肿瘤的 VI-RADS 评分。使用 Youden J 统计量从受试者工作特征曲线分析的最佳工作点估计 VI-RADS 评分的截断值。采用计算敏感度、特异度、阳性预测值（PPV）、阴性预测值（NPV）和准确率来评估 VI-RADS 诊断肌层浸润性肿瘤的效能。
结果
在病变水平，两位观察者对 T2W、DW 和 DCE 三种不同磁共振成像类型的一致性极好（T2W：K 值=0.89；DW：K 值=0.82；DCE：K 值=0.85）。在截断值为 4 分时，T2W 和 DW 成像对肿瘤病灶的肌层浸润诊断准确率为 79.3%（269/339），与总体评分 80.2%（272/339）相当。当整体 VI-RADS 评分≥4 分，其诊断准确率为 80.2%（272/339），敏感度为 91.3%（85/93），特异度为 76.0%（187/246），PPV 为 83.3%（85/102），NPV 为 78.9%（187/237）。当我们将任意整体评分≥3 分作为截断值时，准确率为 63.7%（216/339），敏感度为 94.6%（125/132），特异度为 43.9%（91/207），PPV 为 51.6%（125/242），NPV 为 63.7%（91/97）。
结论
VI-RADS 对肌层浸润性肿瘤的诊断具有较好的整体性能。
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